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Prolonged Implantation of Sinus Devices and Implications for Chronic Rhinosinusitis: A Case Report and Review of the Literature. 鼻窦装置的长期植入及其对慢性鼻窦炎的影响:病例报告和文献综述。
Pub Date : 2020-04-01 Epub Date: 2020-04-28 DOI: 10.31487/j.scr.2020.04.10
Saangyoung E Lee, Drew Cutshaw, Adam J Kimple, Mark W Gelpi, William C Brown, Brian D Thorp, Adam M Zanation, Charles S Ebert

Background: Implantation of sinus stents and spacers can be used as adjuvant management to maintain patency of sinuses after endoscopic sinus surgery for chronic rhinosinusitis. These implants are typically removed several weeks after surgery. We present two cases of different patients who were initially treated by different physicians and were found to have retained sinus spacers in their paranasal sinuses 6-10 years after implantation.

Case presentation: Case 1: a 40-year old male with chronic rhinosinusitis and history of balloon sinuplasty six years prior presented with worsening symptoms of chronic rhinosinusitis refractory to medical management. He underwent revision functional endoscopic sinus surgery and was found to have retained sinus implants in the left and right frontal sinus recesses. Case 2: a 48-year-old female with long-standing chronic rhinosinusitis refractory to medical management presented after two prior sinus surgeries most recently 10 years ago. She underwent revision functional endoscopic surgery and was found to have a retained sinus implant from prior surgery in the right frontal recess outflow tract embedded within scar tissue and reactive hyperostosis. Foreign bodies from both patients were removed without complication and patients were healing appropriately in the post-operative period.

Conclusions: While sinus stents and spacers can help with post-operative scarring, leaving then unmonitored and in place will eventually result in them becoming a nidus for scarring and infection. It is critical that patients are aware of any foreign bodies we place, if they need scheduled removal or routine observation, and what symptoms may indicate that they are causing a problem.

背景:内窥镜鼻窦手术治疗慢性鼻窦炎后,植入鼻窦支架和垫片可作为辅助治疗手段,以保持鼻窦的通畅。这些植入物通常在术后数周后取出。我们介绍了两例不同患者的病例,他们最初由不同的医生进行治疗,但在植入鼻窦垫片 6-10 年后,发现鼻窦垫片仍保留在副鼻窦中:病例 1:一名 40 岁男性,患有慢性鼻窦炎,6 年前曾接受过球囊鼻窦成形术,因慢性鼻窦炎症状加重,药物治疗无效。他接受了功能性内窥镜鼻窦翻修手术,发现左侧和右侧额窦凹陷处有残留的鼻窦植入物。病例 2:一名 48 岁的女性,长期患有慢性鼻窦炎,药物治疗无效,曾接受过两次鼻窦手术,最近一次是在 10 年前。她接受了翻修功能性内窥镜手术,结果发现右额凹流出道内有先前手术遗留的鼻窦植入物,嵌入瘢痕组织和反应性骨质增生中。两名患者的异物均已取出,未发生并发症,术后愈合良好:虽然上颌窦支架和间隔器有助于消除术后瘢痕,但如果不对其进行监控和放置,最终将导致其成为瘢痕和感染的巢穴。至关重要的是,患者要了解我们放置的任何异物,是否需要按计划取出或进行常规观察,以及哪些症状可能表明它们正在造成问题。
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Surgical case reports (Tallinn, Estonia)
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